Thoughts, news, tips on all things process

Thursday May 09, 2013

Can we create a system that can solve mysteries, as Perry Mason would do? Can
there be a single method that can solve all mysteries that Perry Mason solved? No,
we cannot design such a process because each case is different, participants
are different, evidence is different, and conditions are different. If we
cannot design a process for just 82 mysteries, how can we hope design a process
that can solve, let’s say, 1000 new mysteries every week or each day!

We need Perry Mason for that. That is what knowledge workers are; Perry Masons of claims management, health care or fraud management departments.In the first part of blog I discussed the “Adaptive” part of Adaptive Case Management. Here, I’ll talk about “Case”.

Well, not this brief ”case” but maybe related
to it. So if, this were briefcase of Perry Mason, what would it include? It might
contain notes on some clues, interviews of witnesses, a bullet shell, photo of blood
stained shirt, and may be a magnifying glass(ok no magnifying glass, that is Sherlock
Holmes).The “Case Folder” is similar.
It contains all the information collected while the case is being processed and
required to solve a case. It may contain
documents, pictures, notes, history and data.

Once the
case is created it is routed to the person with best skills to solve that case.
There may be collaboration required at each stage of the case. The knowledge
worker may determine what should be the next step in case, he may start related
cases or initiate other necessary processes to resolve the case. There may also
be certain service level agreements (SLA) or metrics associated with the cases.

There are
also rules and policies associated with cases and case types that determine the
constraints or actions in certain conditions. For instance, if a customer is VVIP,
claims agent cannot see the personal information and has to settle the case
within 1 hour, or escalate it.

The cases
can be of different types, they can be investigative like insurance claims,
they can be service requests like employee calling helpdesk reporting slow running
server or can be incident reporting like when a citizen may report a suspicious
activity to local police station.

So we use
this concept of case when there is no pre-determined path that can be followed
to get to the resolution, or permutations and combinations of paths from start
to finish are so numurous that it is impractical to create a process diagram
for it.

Now that we
have seen what “Adaptive” is and what a “Case” refers to, in the next part we’ll
bring these together and discuss management aspect of adaptive case management.